1. Field of the Invention
This invention relates to cerebral palsy impaired speech. This invention also relates to evaluating a subject for and the treatment of a speech impairment secondary to cerebral palsy. In one specific aspect, this invention relates to the treatment of cerebral palsy impaired speech in children and adolescents. This invention also relates to speech, language and communication disorders in children diagnosed with cerebral palsy.
2. Background and Discussion of the Art
Cerebral palsy (CP) is a non-progressive disease or disorder involving irreparably damaged or injured areas of the brain, including connections between the cortex and other parts of the brain (the central nervous system) and the muscles (in the peripheral nervous system).
The National Institute of Neurological Disorders and Stroke (NINDS) of the National Institutes of Health (NIH) defines cerebral palsy as any of a number of neurological disorders that appear in infancy or early childhood and permanently affect body movement and muscle coordination but do not worsen over time, and then makes clear that cerebral palsy cannot be cured, but treatment will often improve a child's capabilities and that such treatment may include physical and occupational therapy, speech therapy, drugs to control seizures, relax muscle spasms, and alleviate pain; surgery to correct anatomical abnormalities or release tight muscles; braces and other orthotic devices; wheelchairs and rolling walkers; and communication aids such as computers with attached voice synthesizers.
There are several causes of cerebral palsy, including maternal trauma or infection resulting in periventricular leukomalacia, genetic mutations resulting in cerebral dysgenesis; fetal stroke resulting intracranial hemorrhage, and hypoxic ischemic encephalopathy. The several causes of cerebral palsy include complications before birth. Such complications may include genetic mutations resulting in cerebral dysgenesis, maternal or fetal infections resulting in encephalomalacia and intra-utero vascular thrombosis (intrauterine strokes). Complications during delivery may result in hypoxic-ischemic encephalopathy. After birth, CP can be the result of non-accidental trauma, encephalitis or meningitis due to any number of infectious or toxic agents.
There are generally three types of cerebral palsy, namely ataxic which includes lack of muscle coordination, spastic, which includes tighter muscles and exaggerated reflexes and movements, i.e. dyskinetic movements, which includes slow and uncontrollable withering. Spastic cerebral palsy is further defined as spastic diplegia and spastic quadriplegia.
Dysarthria is a neurogenic speech disorder that causes dysfunctional speech musculature, that is, tongue, lips, soft palate, facial muscles and larynx. There is low muscle tone or even paralysis of the speech muscles that coordinate with the speech functions. Children suffering from dysarthria are characterized by early sucking, chewing and swallowing problems. Many children “drool” for a long time and continue eating soft foods as they are easy to digest. These children also gag and choke frequently. Dysarthria can be classified as mild-to-moderate, wherein the patient slurs at least some words and, at best, can be understood with some difficulty; or severe, wherein the patent's speech is so slurred as to be unintelligible. Cerebral palsy is a cause of dysarthria. One speech impairment secondary to cerebral palsy is dysarthric speech. Non-bilabial speech is considered to be severe dysarthric speech. Dysarthria is one of the speech impairments treated by the present invention.
The National Institutes of Health (NIH) reports that conventional speech and language therapy for children with cerebral palsy might somewhat improve their communication skills. The NIH summarizes the status of speech muscular therapy attempts to treat cerebral palsy, impaired speech or attempts that can include ways of enhancing natural forms of communication, introducing aids such as symbol charts or devices with synthetic speech, and training communication partners. The NIH finds some weak evidence that speech and language therapy might help children with CP, but more research is needed.
Intensive speech and language therapy over the course of several weeks, such as disclosed in Intensive Speech and Language Therapy for Older Children with Cerebral Palsy; a Systems Approach, Pennington et al., Developmental Medicine & Child Neurology; 2010, 52: 337-344, reports at best a 14% to 16% improvement in the number of single or multiple word responses.
Various mechanical and electro-mechanical devices including electrodes are disclosed in the prior art for treating cerebral palsy impaired speech in children. Such devices are disclosed in U.S. Pat. No. 5,213,553, issued May 25, 1993 to Light; and US2006/0161218, published Jul. 20, 2006 to Danilov. Such treatments have had limited improvement in cerebral palsy impaired speech.
The art related to treating a speech impairment secondary to cerebral palsy in children desires a treatment that readily and substantially diminishes the impairment. The art also desires a treatment as aforesaid wherein the improvement in speech persists without the need for continuous treatment. The present invention accordingly provides a solution.